Maternal Birth Satisfaction Relating to Intraoperative and Early Postpartum Skin-to-Skin Contact with the Neonate During Caesarean Birth: An Integrative Review

Background: Mothers and their newborns experiencing caesarean birth often receive delayed or interrupted skin-to-skin care (SSC) despite the intervention being well recognised as beneficial to both mother and baby, with no associated risk for increased morbidity or mortality. Maternal birth satisfaction is recognised as an indicator of quality maternity care; however, most of the research has focused on early intraoperative SSC initiation and breastfeeding outcomes. Objectives: To collate and synthesise evidence for maternal satisfaction of intraoperative and early postpartum SSC during and immediately following caesarean birth. To identify timelines of implementation, barriers, and facilitators of SSC. Methods: An integrative review was conducted guided by the 5-stage Wittemore and Knalf's framework. Four electronic databases (CINAHL, Medline, PsycINFO, Web of Science) were searched. Key terms were 'Caesarean birth', 'skin-to-skin care', 'maternal satisfaction'. Studies published from 2014 to 5 September 2024 in English language were included. A hand search of potential inclusion articles was also searched to undertake a comprehensive review. The JBI critical appraisal checklist was used to assess the quality of inclusion studies. Results: 17 studies met the selection criteria and were included in this review. Intraoperative and early SSC during caesarean birth is associated with positive maternal birth satisfaction and contributes to improved birth experience for mothers with no negative implications. Conclusions: Increased access to intraoperative SSC will likely contribute to increased maternal satisfaction and positive birthing experience. Compliance with policy recommendations regarding SSC may improve with access to a flow chart tool identifying expectations of women's intraoperative and postoperative care for caesarean birth.